Nortriptyline

Conditions Treated

Nortriptyline is used to treat depression. Nortriptyline is in a group of medications called tricyclic antidepressants. It works by increasing the amounts of certain natural substances in the brain that are needed to maintain mental balance.

Possible Side Effects

What Side Effects Can This Cause?

Nortriptyline may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

• nausea
• drowsiness
• weakness or tiredness
• excitement or anxiety
• nightmares
• dry mouth
• changes in appetite or weight
• constipation
• difficulty urinating
• frequent urination
• blurred vision
• changes in sex drive or ability
• excessive sweating

Some side effects may be serious. If you experience any of the following symptoms or those listed in the IMPORTANT WARNING section, call your doctor immediately:

• jaw, neck, and back muscle spasms
• slow or difficult speech
• shuffling walk
• uncontrollable shaking of a part of the body
• fever
• difficulty breathing or swallowing
• rash
• yellowing of the skin or eyes
• irregular heartbeat

Nortriptyline may cause other side effects. Call your doctor if you have any unusual problems while you are taking this medication.If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online [at http://www.fda.gov/Safety/MedWatch] or by phone [1-800-332-1088].

Usage Instructions

How Should This Medication Be Used

Nortriptyline comes as a capsule and an oral liquid to take by mouth. It is usually taken one to four times a day and may be taken with or without food. Take nortriptyline at around the same times every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take nortriptyline exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor. Your doctor will probably start you on a low dose of nortriptyline and gradually increase your dose. Continue to take nortriptyline even if you feel well. Do not stop taking nortriptyline without talking to your doctor. If you suddenly stop taking nortriptyline, you may experience withdrawal symptoms such as headache, nausea, and weakness. Your doctor will probably want to decrease your dose gradually.

What Dietary Instructions Should I Follow

Unless your doctor tells you otherwise, continue your normal diet.

Are There Any Special Instructions

Before taking nortriptyline, tell your doctor and pharmacist if you are allergic to nortriptyline and other tricyclic antidepressants such as desipramine (Norpramin), clomipramine (Anafranil), imipramine (Tofranil), trimipramine (Surmontil),or any other medications. tell your doctor if you are taking a monoamine oxidase (MAO) inhibitor such as isocarboxazid (Marplan), phenelzine (Nardil), selegiline (Eldepryl, Emsam, Zelapar), and tranylcypromine (Parnate), or if you have stopped taking an MAO inhibitor within the past 14 days. Your doctor will probably tell you not to take nortriptyline. tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements and herbal products you are taking or plan to take. Be sure to mention any of the following: anticoagulants (blood thinners) such as warfarin (Coumadin); antihistamines; chlorpropamide (Diabinese); cimetidine (Tagamet); flecainide (Tambocor); guanethidine (Ismelin); lithium (Eskalith, Lithobid); medication for high blood pressure, seizures, Parkinson's disease, diabetes, asthma, nausea, mental illness, colds, or allergies; methylphenidate (Ritalin); muscle relaxants; propafenone (Rhythmol); quinidine; sedatives; selective serotonin reuptake inhibitors (SSRIs) such as citalopram (Celexa), escitalopram (Lexapro), fluoxetine (Prozac, Sarafem), fluvoxamine (Luvox), paroxetine (Paxil), and sertraline (Zoloft);sleeping pills; thyroid medication; and tranquilizers. Your doctor may need to change the doses of your medications or monitor you carefully for side effects. tell your doctor if you have recently had a heart attack. Your doctor may tell you not to take nortriptyline. tell your doctor if you have or have ever had glaucoma (an eye condition), an enlarged prostate (a male reproductive gland), difficulty urinating, diabetes, seizures, schizophrenia (a mental illness that causes disturbed or unusual thinking, loss of interest in life, and strong or inappropriate emotions), an overactive thyroid gland, or liver, kidney, or heart disease. if you are having surgery, including dental surgery, tell the doctor or dentist that you are taking nortriptyline. you should know that this medication may make you drowsy. Do not drive a car or operate machinery until you know how this medication affects you. talk to your doctor about the safe use of alcohol while you are taking this medication. plan to avoid unnecessary or prolonged exposure to sunlight and to wear protective clothing, sunglasses, and sunscreen. Nortriptyline may make your skin sensitive to sunlight.